Individual provider Active NPI

Karlene Bolman, LMSW

  • Clinical Social Worker
  • Port Huron, MI
National Provider Identifier
1770033656
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114030 Issued in MI
Practice address
2415 24TH St
Port Huron, MI 48060-6414
Phone
(810) 488-8840
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802089116 MI
Clinical Social Worker 1041C0700X 6801114030 MI Primary

Addresses

Primary practice location

2415 24TH St
Port Huron, MI 48060-6414

Mailing address

3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 289-8233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260414002479 MI Practitioner - Clinical Social Worker 0547736985

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1124 Gratiot Blvd
Marysville, MI 48040-1133

5325 Lockwood Dr
Washington, MI 48094-2632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802089116MIMDSocial Worker
6801114030MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1770033656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608127",
            "telephone_number": "810-289-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 24TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606414",
            "telephone_number": "810-488-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLMAN",
        "first_name": "KARLENE",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802089116",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.